Most Relevant Information
Provider Data
| NPI Number: | 1003507120 |
| Provider Name: | KAYLA CHISM |
| Entity Type: | Individual |
| Taxonomy Code: | 225XP0019X |
| Specialty: | Occupational Therapist |
| License Number: | 24109 |
Most Important Dates
| Enumeration Date: | 05/18/2023 |
| Last Updated: | 05/18/2023 |
Provider Practice Location
8477 SUNSET ROSE DR
CORONA
CA
928837322
Practice Location Phone/Fax
| Phone: | 9092783182 |
| Fax: |
Provider Mailing Location
8477 SUNSET ROSE DR
CORONA
CA
928837322
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |